A 45-Year-Old Man Comes to the Emergency Department Due to a 2-Day

question 371

Multiple Choice

A 45-year-old man comes to the emergency department due to a 2-day history of progressively increasing epigastric pain that radiates to the back.  He also has had nausea, an episode of vomiting, and anorexia.  The patient has no chronic medical conditions and takes no medications.  Temperature is 38.3 C (101 F) , blood pressure is 116/78 mm Hg, pulse is 104/min, and respirations are 22/min.  BMI is 27 kg/m².  Mucous membranes are moist.  Breath sounds are decreased at both lung bases.  The abdomen is mildly distended, and bowel sounds are decreased; there is epigastric tenderness with voluntary guarding.  No rebound tenderness or rigidity is noted.  Laboratory results are as follows: Which of the following findings in this patient is associated with the worst prognosis?

• A)Abdominal examination findings
• B)Blood urea nitrogen level
• C)Body mass index
• D)Hematocrit level
• E)Lipase level

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